Research suggests that more than half of children with autism spectrum disorder, a neurodevelopmental condition, experience motor impairments. An analysis in Developmental Medicine & Child Neurology indicates that sports-based interventions may improve motor skills in children with autism spectrum disorder, with martial arts and aquatic training demonstrating the most consistent benefits.
The analysis was based on data from 11 clinical trials of various sports. Martial arts demonstrated consistently large improvements in balance, total motor skills, and object control skills, with especially strong effects in Tai Chi Chuan and kata programs. Aquatic training demonstrated large improvements across balance, locomotor skills, and object control skills. Gymnastics and trampoline interventions demonstrated large improvements in balance and bilateral coordination, with additional effects on total motor scores in trampoline studies. Table tennis produced broad gross motor improvements, and Australian football had a large effect on object control skills and had a medium effect on balance and total motor skills. Across all sports categories, balance was the most consistently improved motor domain.
The authors noted that many of the studies had significant limitations, however, and higher-quality studies are needed.
“Organized sports-based interventions may offer benefits beyond recreation for children with autism by supporting motor skill development,” said corresponding author Sonia Khurana, PT, PhD, of Old Dominion University. “While our review identified promising effects, particularly for martial arts and aquatic training, larger and more rigorous studies are needed to confirm these benefits and guide evidence-based recommendations.”
Increased brain ageing was associated with dementia, addiction and psychiatric disorders like schizophrenia
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People with dementia, mild cognitive impairment, alcohol addiction, or psychiatric disorders such as schizophrenia show increased brain ageing, each in specific patterns within the brain, according to a study published July 21st in the open access journal PLOS Medicine by Shile Qi from the Nanjing University of Aeronautics and Astronautics, China, and colleagues.
Some conditions can make the brain age faster. Scientists calculate how old the brain is relative to the body using the predictive age difference (PAD), the difference between chronological age and the age predicted by brain imaging, where a positive PAD indicates that ageing is accentuated or increased. To better understand how brain disorders and divergences might affect brain ageing, the authors of this study collected structure magnetic resonance imaging (MRI) data from 45 900 controls across several brain imaging banks, and compared them with those of 2698 patients with different brain conditions and differences, including attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), alcohol or tobacco addiction, Alzheimer’s disease (AD), mild cognitive impairment (MCI), schizophrenia, bipolar disorder or major depressive disorder.
The authors found that neurodegenerative disorders of AD and MCI had the largest association with a high PAD. Addiction and psychiatric disorders were also associated with increased PAD. In contrast, there were no differences in PAD between people with ADHD or ASD and controls.
The researchers also looked at PAD values in specific areas of the brain, and examined which genes showed increased expression in people with different brain conditions. The prefrontal cortex showed higher PAD across brain disorders. Higher PAD in the frontal and temporal lobes was associated with psychiatric disorders, while high PAD in the frontal and occipital cortex was associated with dementia. Addiction was connected with high PAD in the default mode network, and in the salience network and the putamen and thalamus. There were also differences in gene transcription that associated with specific conditions and divergences. While the results are correlational, and not causal, and while some conditions such as psychiatric disorders and addiction have high co-occurrence, the author suggest that understanding more about PAD could help provide biomarkers for commonly occurring brain disorders.
The authors add, “Different neurological disorders appear to leave different signatures on the brain ageing clock, which may help researchers better understand the neural and biological pathways involved in these conditions.”
When it comes to autism, few questions spark as much debate as how best to support autistic people with the greatest needs.
This prompted The Lancet medical journal to commission a group of international experts to propose a new category of “profound autism”.
This category describes autistic people who have little or no language (spoken, written, signed or via a communication device), who have an IQ of less than 50, and who require 24-hour supervision and support.
It would only apply to children aged eight and over, when their cognitive and communication abilities are considered more stable.
In our new study, we considered how the category could impact autism assessments. We found 24% of autistic children met, or were at risk of meeting, the criteria for profound autism.
Why the debate?
The category is intended to help governments and service providers plan and deliver supports, so autistic people with the highest needs aren’t overlooked. It also aims to re-balance their under-representation in mainstream autism research.
This new category may be helpful for advocating for a greater level of support, research and evidence for this group.
But some have raised concerns that autistic people who don’t fit into this category could be perceived as less in need and excluded from services and funding supports.
Others argue the category doesn’t sufficiently emphasise autistic people’s strengths and capabilities, and places too much emphasis on the challenges that are experienced.
What did we do?
We conducted the first Australian study to examine how the “profound autism” category might apply to children attending publicly funded diagnostic services for developmental conditions.
Drawing on the Australian Child Neurodevelopment Registry, we examined data from 513 autistic children assessed between 2019 and 2024. We asked:
how many children met the criteria for profound autism?
were there behavioural features that set this group apart?
Because we focused on children at the time of diagnosis, most (91%) were aged under eight years. We described these children as being “at risk of profound autism”.
What did we find?
Around 24% of autistic children in our study met, or were at risk of meeting, the criteria for profound autism. This is similar to the proportion of children internationally.
Almost half (49.6%) showed behaviours that were a safety risk, such as attempting to run away from carers, compared with one-third (31.2%) of other autistic children.
These challenges weren’t limited to children who met criteria for profound autism. Around one in five autistic children (22.5%) engaged in self-injury, and more than one-third (38.2%) showed aggression toward others.
So, while the category identified many children with very high needs, other children who didn’t meet these criteria also had significant needs.
Importantly, we found the definition of “profound autism” doesn’t always line up with the official diagnostic levels which determine the level of support and NDIS funding children receive.
In our study, 8% of children at risk of profound autism were classified as level 2, rather than level 3 (the highest level of support). Meanwhile, 17% of children classified as level 3 did not meet criteria for profound autism.
Our concern
We looked at children when they first received an autism diagnosis. Children were aged 18 months to 16 years, with more than 90% under the age of eight years.
This aligns with our earlier research, showing the average age of diagnosis in public settings is 6.6 years.
From a practical perspective, our biggest concern about the profound autism category is the age threshold of eight years.
Because most children are already assessed before age eight, introducing this category into assessment services would mean many families would need repeat assessments, placing additional strain on already stretched developmental services.
Second, modifications will be needed if this criteria is going to be used to inform funding decisions as it didn’t map perfectly onto level 3 support criteria.
On balance, however, our results suggest the profound autism category may provide a clear, measurable way to describe the needs of autistic people with the highest support requirements.
Every autistic child has individual strengths and needs. The term “profound autism” would need to be promoted with inclusive and supportive language, so as to not replace or diminish individual needs, but to help clinicians tailor supports and obtain additional resources when needed.
If you’re concerned your child requires substantial support, here are some practical steps you can take to ensure their needs are recognised and addressed:
Explain your concerns
Not all clinicians have experience working with children with high support needs. Be as clear as possible about behaviours that affect your child’s safety or daily life, including self-injury, aggression or attempts to run away. These details, while difficult to share, help give a clearer picture of your child’s support needs.
It can also be a challenge to find and access clinicians with appropriate expertise. Another potential benefit of having a defined category is that it can better help families navigate care.
Ask about support for the whole family
Our studies show that many caregivers want more support for themselves but don’t always ask. Talk with clinicians about supports for yourself as well, including respite, or family support groups.
Reach out
Coming together with other carers and families can reduce your own isolation and normalise many of the unique challenges you face. Connecting with like-minded people can provide a supportive, empathetic and empowering community.
Plan for safety
For children with high support needs, prioritise safety planning with your child’s care team. This can include strategies to reduce risks, as well as planning how best to support your child’s interactions with health, education and disability services over time.
National study found use of the drug rose sharply following major media coverage and later White House promotion, despite limited large-scale evidence for autism treatment
Leucovorin prescriptions for children with autism rose more than 2000% by late 2025. Courtesy of UC San Diego Health Sciences.
Researchers from the University of California San Diego found that prescriptions for leucovorin, a drug sometimes used off-label for autism spectrum disorder (ASD), rose sharply among children after widespread media attention and public statements from White House officials. The study, published May 18, 2026 in JAMA Network Open, analysed national electronic health record data and found prescribing rates increased more than 2000% compared with prior years.
“Families of children with autism are often searching for therapies that might improve communication and quality of life, especially when treatment options are limited,” said Joshua Rothman, MD, clinical assistant professor of pediatrics at the UC San Diego School of Medicine and first author of the study. “What this study shows is how quickly information shared through news coverage, social media and public figures can influence real-world prescribing patterns, even before large clinical trials establish whether a treatment is truly safe and effective for broad use.”
Leucovorin, also known as folinic acid, is a biologically active form of folic acid. Small clinical trials have suggested that some children with autism and folate-related deficiencies may experience improvements in verbal communication after taking the medication. However, researchers note that large-scale studies confirming the drug’s effectiveness and long-term safety for children with ASD have not yet been completed.
To better understand prescribing trends, the researchers analysed records from the Epic Cosmos database, which includes more than 300 million patient records from over 1800 hospitals and 41 500 clinics across all 50 states and Washington, D.C. The study focused on 838 801 children with autism who accounted for more than 11.9 million outpatient encounters between January 2023 and January 2026.
For roughly two years, leucovorin prescribing rates remained relatively stable, averaging about 34 prescriptions per 100 000 outpatient encounters among children with autism. Rates then began climbing steadily in early 2025 before surging later that year. By August 2025, prescribing rates had risen to 335 prescriptions per 100 000 encounters. In November 2025, rates climbed again to more than 835 prescriptions per 100,000 encounters.
The researchers observed that the initial rise in prescribing coincided with a February 2025 national television news segment featuring a family who reported dramatic language improvements in their child after treatment with leucovorin. Interest in the medication expanded further after White House officials publicly promoted leucovorin in September 2025 as part of broader autism-related initiatives.
“Families of children with autism are often searching for therapies that might improve communication and quality of life, especially when treatment options are limited. What this study shows is how quickly information shared through news coverage, social media and public figures can influence real-world prescribing patterns, even before large clinical trials establish whether a treatment is truly safe and effective for broad use.”
— Joshua Rothman, MD, clinical assistant professor of paediatrics at the UC San Diego School of Medicine and first author of the study
“The timing was striking,” Rothman said. “The increases began after a widely viewed media story and accelerated again after federal officials publicly discussed the medication. It highlights how rapidly clinical practice can shift when a treatment captures public attention.”
The study does not determine whether leucovorin improves symptoms of autism, nor does it evaluate patient outcomes after treatment. Researchers also cautioned that prescriptions recorded in the database could not always be linked to a confirmed medical indication.
Still, the authors say the rapid increase in use raises important questions for clinicians, policymakers and families. In March 2026, the US Food and Drug Administration approved leucovorin for cerebral folate transport deficiency, an ultra-rare genetic neurological disease associated with specific genetic changes, but the drug was not approved for autism spectrum disorder.
Researchers say the findings underscore the need for continued monitoring of prescribing trends and for larger randomised clinical trials evaluating whether leucovorin is beneficial for specific groups of children with autism.
“We now have a real-world example of how public attention can accelerate adoption of a therapy before the evidence fully catches up,” Rothman said. “The next step is making sure we generate the rigorous data needed to help families and clinicians make informed decisions.”
Children with epilepsy have a higher risk of also having autism spectrum disorder (ASD). A new study in Developmental Medicine & Child Neurology examined factors associated with the co-occurrence of autism and epilepsy in a large population-based group.
For the study, investigators at the Mayo Clinic compared the prevalence of autism spectrum disorder in children with and without epilepsy based on medical records, and they evaluated associated factors including sex, age at autism identification, and intellectual disability. The study included 30 490 children in the Olmsted County, Minnesota birth cohort, of whom 257 (0.84%) had epilepsy diagnosed before 19 years of age.
Autism prevalence was significantly higher among children with epilepsy as compared with children without across all three research and clinical definitions assessed (21.4% versus 3.2% using broad research criteria, 14.0% versus 1.6% using stricter research criteria, and 7.9% versus 0.7% for clinical diagnosis).
Children with epilepsy and autism were more likely to have intellectual disability (56.5% versus 15.4%), were more often female (38.2% versus 25.8%), and were identified with autism at a younger age (7.4 versus 8.7 years) compared with those without autism.
“These observations highlight clinically relevant differences within this group and underscore the importance of early recognition of developmental concerns,” said lead author Mariya Saify. MBBS.
Senior author Elaine C. Wirrell, MD added that although children with epilepsy are at an elevated risk of autism, recognition can be delayed. “Our findings emphasise the importance of screening for autism in this population to support earlier diagnosis and timely intervention, both of which are key to improving long-term outcomes.”
M-CHAT does not catch all children with autism in the neonatal high-risk group, shows a study from Karolinska Institutet published in JAMA Network Open. The researchers see a need to supplement the test with other assessment methods.
Children born very prematurely or with complications are screened at the age of two for early signs of autism using the M-CHAT questionnaire. In a new national study, researchers at Karolinska Institutet have investigated how well the test works in this high-risk group. The study includes 2178 children born in Sweden between 2013 and 2019 and compares M-CHAT results with later clinical diagnoses of autism.
The researchers found that the test was highly accurate in ruling out autism, but that many children with autism were still missed. The sensitivity was 62%, while the specificity – the ability to identify children without autism – was 91%. In total, 12% of the children received a positive M-CHAT result and 6% were later diagnosed with autism.
“The results show that M-CHAT works relatively well to rule out autism, but that it does not catch all children who later receive a diagnosis. In this high-risk group, more tools are therefore needed to detect children who need further investigation early,” says Ulrika Ådén, professor at the Department of Women’s and Children’s Health.
Children born extremely prematurely had both the highest proportion of positive test results and the most autism diagnoses. The researchers also saw that girls had fewer positive test results than boys, and that linguistic factors could affect the outcome – the test had higher specificity in families that spoke a Scandinavian language.
“Overall, the study shows that other developmental difficulties, such as motor or sensory problems, can affect how M-CHAT is interpreted. This needs to be taken into account when healthcare works with early screening,” says Ulrika Ådén.
Study raises questions around why female individuals are diagnosed later than males
Photo by Ben Wicks on Unsplash
Autism has long been viewed as a condition that predominantly affects male individuals, but a study from Sweden published by The BMJ shows that autism may actually occur at comparable rates among male and female individuals.
The results show a clear female catch-up effect during adolescence, which the researchers say highlights the need to investigate why female individuals receive diagnoses later than male individuals.
The prevalence of autism spectrum disorder (ASD) has increased over the past three decades, with a high male-to-female diagnosis ratio of around 4:1.
The increase in prevalence is thought to be linked to factors including wider diagnostic criteria and societal changes (eg, parental age), whilst the high male to female ratio has been attributed to better social and communication skills among girls, making autism more difficult to spot. However so far no large study has examined these trends over the life course.
To address this, researchers used national registers to analyse diagnosis rates of autism for 2.7 million individuals born in Sweden between 1985 and 2022 who were tracked from birth to a maximum of 37 years of age.
During this follow-up period of more than 35 years, autism was diagnosed in 78,522 (2.8%) of individuals at an average age of 14.3 years.
Diagnosis rates increased with each five year age interval throughout childhood, peaking at 645.5 per 100,000 person years for male individuals at age 10-14 years and 602.6 for female individuals at age 15-19 years.
However, while male individuals were more likely to have a diagnosis of autism in childhood, female individuals caught up during adolescence, giving a male to female ratio approaching 1:1 by age 20 years.
This is an observational study and the authors acknowledge that they did not consider other conditions associated with autism, such as ADHD and intellectual disability. Nor were they able to control for shared genetic and environmental conditions like parental mental health.
However, they say the study size and duration enabled them to link data for a whole population and disentangle the effects of three different time scales: age, calendar period and birth cohort.
As such, they write: “These findings indicate that the male to female ratio for autism has decreased over time and with increasing age at diagnosis. This male to female ratio may therefore be substantially lower than previously thought, to the extent that, in Sweden, it may no longer be distinguishable by adulthood.”
“These observations highlight the need to investigate why female individuals receive diagnoses later than male individuals,” they conclude.
These findings align with recent research and seem to support the argument that current practices may be failing to recognise autism in many women until later in life, if at all, says Anne Cary, patient and patient advocate, in a linked editorial.
She notes that studies like this are essential to changing the assumption that autism is more prevalent in male individuals than in female individuals, but points out that as autistic female individuals await proper diagnosis, “they are likely to be (mis)diagnosed with psychiatric conditions, especially mood and personality disorders, and they are forced to self-advocate to be seen and treated appropriately: as autistic patients, just as autistic as their male counterparts.”
There’s no scientific evidence that the gut microbiome causes autism, a group of scientists argue in an opinion paper published in the international Cell Press journal Neuron.
They say conclusions from past research that supported this hypothesis – including observational studies, mouse models of autism, and human clinical trials – are undermined by flawed assumptions, small sample sizes, and inappropriate statistical methods.
“Despite what you’ve heard, read, or watched on Netflix, there is no evidence that the microbiome causally contributes to autism,” says first author and developmental neurobiologist Prof Kevin Mitchell from Trinity.
The hypothesis that autism is caused, at least partially, by the gut microbiome stems from the fact that many people with autism suffer from gastrointestinal symptoms.
In addition, the recent rise in autism diagnoses has led some to believe that environmental or behavioural changes are driving an increase in autism, though the authors note there is strong evidence that the rise in diagnoses reflects increased awareness and broadened diagnostic criteria rather than a biological mechanism.
Nevertheless, researchers have pursued the microbiome-autism hypothesis by comparing the gut microbiomes of people with and without autism, by studying mouse models of autism, and by conducting clinical trials involving people with autism. The authors argue that in all of these studies, the results are flawed and unconvincing.
“There’s variability in all three of those areas, and the studies just don’t form a coherent story at all,” says senior author and developmental neuropsychologist Dorothy Bishop of the University of Oxford.
In the most highly cited studies comparing the gut microbiomes of people with and without autism, researchers used sample sizes ranging from 7 to 43 individuals per group, whereas statistical recommendations call for sample sizes in the thousands.
“Autism is not rare, so there’s no reason to be having studies with only 20, 30, or 40 participants,” says co-author and biostatistician Darren Dahly of the University College Cork.
These studies also used varying methods to characterise microbiome composition, which makes their results difficult to compare. And although some studies found differences between the microbiomes of people with autism and controls, these differences were often contradictory—for example, some studies found lower microbial diversity in the guts of people with autism, while others found the opposite.
These differences also disappeared when the studies accounted for other variables, such as diet, or when they compared the microbiomes of children with autism with their neurotypical siblings.
“If anything, there is stronger evidence for a reverse causal effect, in that having autism can affect someone’s diet, which can affect their microbiome,” says Prof Mitchell.
Mouse models of autism that have claimed to show a link between the gut microbiome and autism are also unconvincing, the researchers say, because of behavioural, cognitive, and physiological differences between humans and mice.
“There’s no evidence that ‘autistic-like’ behaviours in mice models have any relevance to autism, and the experiments themselves had methodological and statistical flaws that undermine their claims,” says Prof Mitchell.
Several human clinical trials have tested the microbiome-autism hypothesis by performing faecal transplants or by administering probiotic therapies to people with autism and then monitoring changes in their characteristics. Again, the researchers say that most of these studies used inadequate sample sizes and inappropriate statistical methods that undermine their findings, and many didn’t use a control group or randomisation.
“The consensus across the studies that we surveyed is that when you do the trials properly, you don’t see anything,” says Dahly.
Based on the lack of convincing evidence, and the lack of progress in the field, the researchers argue the hypothesis that the microbiome causes autism has reached a dead end.
“If you accept our message, there’s two ways you can go. One is to just stop working on this area, which is something that we would be quite happy to see,” says Bishop. “But given that realistically, people are not going to stop, they need to at least start doing these studies in a much more rigorous way.”
Researchers at UTHealth Houston are examining the biological effects of prenatal cannabis exposure and its potential impact on foetal brain development. Supported by a $3.7 million grant from the National Institutes of Health and the National Institute on Drug Abuse, the study aims to improve screening tools, public health guidance, and prenatal care strategies for pregnant people who use cannabis.
Led by Laura Goetzl, MD, MPH, a professor in the Department of Obstetrics, Gynecology, and Reproductive Sciences at McGovern Medical School at UTHealth Houston, the five-year grant will fund the study, “Foetal neuronal extracellular vesicle biomarkers of in-utero effects of maternal cannabinoid use and human foetal brain development and neurobehavioral outcomes.”
“In recent years, cannabis use among pregnant women has increased, either recreationally or to help relieve nausea and vomiting during pregnancy,” Goetzl said. “Despite this rise, the effects on a baby’s brain are not well understood. Our hope through this research is that we can better identify risk factors and help health care providers give expecting mothers the best possible guidance.
The study will explore early biological signs, or biomarkers, to show how cannabis exposure influences a baby’s developing brain.
“During pregnancy, small bubbles called neuronal extracellular vesicles travel from the foetus into the mother’s bloodstream,” Goetzl said. “Through studying these small particles, we hope to gain valuable insight into foetal brain development without invasive testing.”
In collaboration with the University of Colorado, the research study will focus on how prenatal cannabis exposure may influence brain growth and neurobehavioral outcomes in children, including their potential for developing attention-deficit/hyperactivity disorder (ADHD) or autism later in life.
The project is supported by the National Institute on Drug Abuse of the National Institutes of Health under award number R01DA060319.
Pretoria, 28 September 2025 – The South African Health Products Regulatory Authority (SAHPRA) wishes to reassure the public that paracetamol remains a safe and recommended option for the relief of pain and fever during pregnancy, when used short-term at recommended doses.
Paracetamol is one of the most widely used medicines globally and has been extensively studied for decades. There is currently no scientific evidence that using paracetamol in pregnancy causes attention-deficit hyperactivity disorder (ADHD) and autism.
SAHPRA will continue to monitor emerging evidence on the safety of paracetamol.
Advice for healthcare professionals
Paracetamol remains a recommended safe treatment for pain or fever in pregnant women. Pregnant women should be reassured that there is no evidence that taking paracetamol during pregnancy causes autism or ADHD in children. Healthcare professionals are encouraged to provide counselling to patients about the side effects of paracetamol, as detailed in the product’s professional information and patient information leaflet (https://pi-pil-repository.sahpra.org.za/).
Advice for healthcare professionals to provide to patients
Pregnant women and those planning a pregnancy should be advised to use paracetamol only when needed and at the lowest effective dose for the shortest possible time. Untreated fever and pain may pose risks to the unborn baby, and it is therefore important to seek treatment if recommended by a healthcare professional. Pregnant women should consult a healthcare professional if pain or fever persists or if they have any concerns about medicine use during pregnancy. Pregnant women should also be advised to avoid combining paracetamol with other medicines without first seeking medical advice.
Report any suspected adverse drug reactions
Healthcare professionals and members of the public are urged to report any suspected adverse drug reactions (ADRs) related to the use of paracetamol and other health products to SAHPRA via the eReporting link available on the SAHPRA website (www.sahpra.org.za) or complete an ADR reporting form accessible via the SAHPRA website and email it to adr@sahpa.org.za. Alternatively, reporting can be done via the Med Safety App, downloadable through Google Play or the Apple App Store.
SAHPRA remains committed to ensuring the safety of medicines available in South Africa and will update the public if new scientific evidence changes current recommendations.
